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Two health IT executives describe problem programs.

Mobile electronic health records aren’t all they’re cracked up to be, say two health IT executives who managed sputtering mobile EHR initiatives at their hospitals.

When Northern California’s Sutter Health hospital system deployed a mobile EHR project for home health care in 2005, about 60 percent of the things that could go wrong did just that, says Philip Chuang, director of information services.

The program gave home health-care providers laptops and mobile air cards, but they didn’t use them because the computers took too long to boot up, make mobile connections and launch the EHR application, Chuang said last week at the mHealth World Congress in Boston.

“Some of it was the vendor and some of it was us making bad choices,” Chuang said, according to a report published Tuesday by CMIO. “When we looked at the cost to fix all of the system’s issues and finish the rollout, it was a big number. We didn’t know if it was the right horse to bet on.”

The other problem, he said, was that the health system wasn’t clear in its goals before launching the program.

The program wasn’t a total failure. Using lessons learned, Sutter’s mobile clinicians now use smartphones instead of laptops, and they are transitioning to tablet computers, reportsFor the Record.
Seven-inch tablets with Bluetooth-enabled keyboards are better than smartphones for data entry, Chuang says in CMIO, and the small tablets still fit in lab coat pockets.

But training users on the mobile app is taking longer than expected, Chuang said, and testing is an ongoing issue.

“There’s a presumption that a mobile app is always easy to use and that’s what our vendor sold us on,” Chuang said in the CMIO article. “That didn’t turn out to be true.”

An mHealth deployment at the Cleveland Clinic came with its own challenges, CMIO reported.

The hospital had to build a mobile architecture on top of its proprietary EHR system to “liberate” data to go mobile, said Dr. William H. Morris, vice chairman of clinical informatics. In addition, the hospital still hasn’t worked out rules on clinical use of mobile apps.

“We see the commercial arm of mobility flying ahead. . . and healthcare is just beginning to take advantage of that,” Morris said.